Phase 4
N=223
Apnea in Hospitalized Preterm Infants Following the Administration of Routine Childhood Vaccines
Apnea · Apnea Neonatal · Prematurity
Bottom Line
View on ClinicalTrials.gov: NCT03530124 ↗Enrolled (actual)
223
Serious AEs
0.4%
Results posted
Jan 2023
Primary outcome: Primary: Occurrence of Apnea — 25; 12; 80; 104 Participants — p=0.0104
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- PCV13 (Biological); DTaP (Biological); HBV (Biological); IPV (Biological); Hib (Biological)
- Age
- Pediatric, Adult, Older Adult · 0+ yrs
- Sex
- All
- Sponsor
- Duke University
- Primary completion
- Nov 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Occurrence of Apnea |
25; 12; 80; 104; 2; 0 | 0.0104 sig |
| SECONDARY Number of Apneic Episodes |
2.72; 2.00 | 0.11 |
| SECONDARY Duration of Apneic Episodes |
27.7; 32.3 | 0.36 |
| SECONDARY Increase in Respiratory Support |
8; 4; 92; 112; 7; 0 | 0.3555 |
| SECONDARY Severe Cardiorespiratory Events |
7; 8; 31; 34; 1; 0 | 1.0000 |
| SECONDARY Positive Pressure Ventilation |
2; 1; 104; 115; 1; 0 | 1.0000 |
Summary
A prospective, randomized open-label clinical trial will be conducted from July 2018 to October 2020. Approximately 300 preterm infants will be enrolled across three sites: Duke University Medical Center, the University of North Carolina, and Cincinnati Children's Hospital Medical Center. Eligible infants will be randomized 1:1 to receive either 2-month US licensed childhood vaccines (PCV13, DTaP, HBV, IPV an Hib) or no vaccines. After their participation in the study, healthcare providers of the infants in the unvaccinated group will make decision abut receipt of their 2-month childhood vaccines. The study will collect data from the continuous cardiorespiratory and pulse oximetry monitors from randomization to 48 hours after randomization for infants in the unvaccinated group, and from randomization to 48 hours after vaccination for infants in the vaccinated group. Infants in both groups will be monitored for up to 60 hours for the occurrence of apnea, bradycardia, and oxygen desaturation. For infants in the "vaccinated" group, the study will also collect adverse events of clinical interest and serious adverse events occurring between the end of the 48-hour monitoring period and 14 days after vaccination. This information will be collected through parental report and review of medical records.
Eligibility Criteria
Inclusion Criteria
- <33 and 0 days weeks gestational age at birth
- ≥6 weeks and 0 days and ≤12 weeks and 0 days postnatal age at randomization
- Remains hospitalized after birth (has never been discharged home)
- Treating clinician deems infant eligible to receive 2-month vaccines
- English- or Spanish-speaking parent(s)/legally authorized representative(s) (LAR(s))
- Not planned for discharge within 60 hours of study entry
- The parent/guardian must be willing and capable of providing permission for their child to participate through the written informed consent process
Exclusion Criteria
- Receipt of DTaP, IPV, PCV13, or Hib prior to enrollment. Previous administration of the first dose of HBV is permitted
- Anticipated receipt of any vaccine other than DTaP, IPV, HBV, PCV13, or Hib during the first 60 hours after randomization
- History of a severe allergic reaction (e.g. anaphylaxis) to a previous dose of any hepatitis B vaccine
- History of a severe allergic reaction (e.g. anaphylaxis) to any component of the vaccines used in the study including neomycin, yeast and polymyxin B
- History of latex allergy
- Fever ≥38°C within 48 hours prior to randomization*
*This may result in a temporary delay of randomization
- Active known respiratory infection within 48 hours prior to randomization*
*This may result in a temporary delay of randomization
- Active infection being treated with systemic antimicrobials*
*This may result in a temporary delay of randomization
- Requiring mechanical ventilation or support with nasal intermittent positive pressure ventilation (NIPPV)*
*This may result in a temporary delay of randomization
- History of unstable progressive neurologic disorder of unknown cause
- Known cause of apnea other than apnea of prematurity
- Cyanotic heart disease (congenital or acquired)
- Major invasive medical or surgical procedure (including circumcision) within 48 hours prior to randomization or anticipated to have major invasive medical or surgical procedure during the first 60 hours after randomization*
*This may result in a temporary delay of randomization
- Child or parent/LAR is an immediate relative of study staff or an employee who is supervised by study staff.
- Any condition that would, in the opinion of the site investigator, place the participant at an unacceptable risk of injury or render the participant unable to meet the requirements of the protocol
Data sourced from ClinicalTrials.gov (NCT03530124). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.